title: A comparison of two open surgical cricothyroidotomy techniques by military medics using a cadaver model.
abstract: OBJECTIVE
  The CricKey is a novel surgical cricothyroidotomy device combining the functions of a tracheal hook, stylet, dilator, and bougie incorporated with a Melker airway cannula. This study compares surgical cricothyroidotomy with standard open surgical versus CricKey technique.
  
  
  METHODS
  This was a prospective crossover study using human cadaveric models. Participants included US Army combat medics credentialed at the emergency medical technician-basic level. After a brief anatomy review and demonstration, participants performed in random order standard open surgical cricothyroidotomy and CricKey surgical cricothyroidotomy. The primary outcome was first-pass success, and the secondary outcome measure was procedural time.
  
  
  RESULTS
  First-attempt success was 100% (15/15) for CricKey surgical cricothyroidotomy and 66% (10/15) for open surgical cricothyroidotomy (odds ratio 16.0; 95% confidence interval 0.8 to 326). Surgical cricothyroidotomy insertion was faster for CricKey than open technique (34 versus 65 seconds; median time difference 28 seconds; 95% confidence interval 16 to 48 seconds).
  
  
  CONCLUSIONS
  Compared with the standard open surgical cricothyroidotomy technique, military medics demonstrated faster insertion with the CricKey. First-pass success was not significantly different between the techniques.
authors.affiliation: San Antonio Military Medical Center, Fort Sam Houston, TX. Electronic address: robert.l.mabry8.mil@mail.mil.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Mabry
authors.affiliation: San Antonio Military Medical Center, Fort Sam Houston, TX.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Nichols
authors.affiliation: San Antonio Military Medical Center, Fort Sam Houston, TX.
authors.forename: Drew C
authors.initials: DC
authors.lastname: Shiner
authors.affiliation: Bulverde-Spring Branch Emergency Medical Services, Spring Branch, TX.
authors.forename: Scotty
authors.initials: S
authors.lastname: Bolleter
authors.affiliation: Texas Health Resources, Dallas, TX.
authors.forename: Alan
authors.initials: A
authors.lastname: Frankfurt
mesh_terms: D002102:Cadaver; D003413:Cricoid Cartilage / Q000601:surgery; D018592:Cross-Over Studies; D006801:Humans; D008887:Military Medicine / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D014139:Tracheostomy / Q000295:instrumentation / Q000379:methods*